Abstract In this educational post, I share how I evaluate and manage persistent lateral elbow and dorsal forearm pain consistent with radial tunnel syndrome and posterior interosseous nerve entrapment. I explain the ultrasound-guided hydrodissection technique from my first-person perspective, emphasizing safety, anatomy, and technique nuances. I present the clinical reasoning for using perineural hydrodissection, outline evidence-based protocols that combine chiropractic biomechanical corrections, medical oversight, and functional medicine strategies, and discuss post-procedure rehabilitation to improve outcomes. I also describe our multidisciplinary care model at Injury Medical Clinic PA (Mission Plaza Injury Medical Clinic) in El Paso, Texas, where I collaborate with Dr. Maria Guadalupe Cardenas, MD—Board Certified in Internal Medicine (NPI #1164426749, Texas MD License #J2933)—who serves as our Medical Director and Collaborative Physician. Together, we integrate chiropractic ca...
Abstract As a clinician dedicated to integrating cutting-edge, evidence-based therapies, I continually explore innovative methods to address complex musculoskeletal conditions. In this educational post, we will journey into the advanced technique of High-Volume Injection (HVI) , also known as brisement , a powerful tool for managing chronic tendinopathies. Drawing on the latest research and clinical expertise, I will explain the physiological principles behind this procedure, its application for conditions like Achilles and patellar tendinopathy, and how it represents a significant leap forward from traditional treatments. We'll explore the "why" and "how" of HVI, detailing hydrostatic tissue decompression and the disruption of pain-generating neovessels and neonerves. This post aims to provide a clear, easy-to-understand guide for patients and practitioners alike, illuminating how this modern intervention integrates into a comprehensive care plan, such as the o...
